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Major study finds common steroid reduces deaths among patients with severe Covid-19

In March 2020, the RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial was established as a randomised clinical trial to test a range of potential treatments for COVID-19, including low-dose dexamethasone (a steroid treatment). Over 11,500 patients have been enrolled from over 175 NHS hospitals in the UK. On 8 June, recruitment to the dexamethasone arm was halted since, in the view of the trial Steering Committee, sufficient patients had been enrolled to establish whether or not the drug had a meaningful benefit. A total of 2104 patients were randomised to receive dexamethasone 6 mg once per day (either by mouth or by intravenous injection) for ten days and were compared with 4321 patients randomised to usual care alone. Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%). Dexamethasone reduced deaths by one-third in ventilated patients (rate ratio 0.65 [95% confidence interval 0.48 to 0.88]; p=0.0003) and by one fifth in other patients receiving oxygen only (0.80 [0.67 to 0.96]; p=0.0021). There was no benefit among those patients who did not require respiratory support (1.22 [0.86 to 1.75]; p=0.14).

Source: https://www.recoverytrial.net/files/recovery_dexamethasone_statement_160620_v2final.pdf

Epidemiology of Obstructive Sleep Apnea: a Population-based Perspective

Several population-based studies across various geographical regions and ethnic groups have established a high prevalence of OSA. This epidemic of OSA is closely related to the obesity epidemic—an important public health related condition facing adults globally. In the United States in 2004, the estimated prevalence of adult obesity, classified as a body mass index (BMI) over 30 kg/m2, was more than 30% and the prevalence of extreme obesity (BMI > 40 kg/m2) was 2.8% in men and 6.7% in women [1]. Associated health care expenditures in obese individuals is 36% higher than normal weight persons, and it has been estimated that up to 7% of the annual health care expenditures is related to obesity [2,3]. Obesity is a well-recognized risk factor for a variety of medical conditions such as OSA, type 2 diabetes, cardiovascular diseases, hyperlipidemia, metabolic syndrome, and nonalcoholic fatty liver disease.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2727690/

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